A recent clinical study found that ciprofol was as effective as propofol for anesthesia induction in elderly patients undergoing lumbar surgery but led to significantly lower rates of hypotension and better hemodynamic stability.
In their randomized controlled trial, Gang Yao, of The First Affiliated Hospital of Guangxi Medical University in Nanning, China, and colleagues divided 60 patients aged 65 to 80 years who were scheduled for elective lumbar spine surgery into 2 groups. One group received ciprofol at 0.4 mg/kg, and the other received propofol at 2 mg/kg. Both groups also received sufentanil at 0.4 µg/kg.
The researchers aimed to determine whether ciprofol could deliver equivalent anesthetic effects to propofol while minimizing hemodynamic fluctuations—an important concern in older adults due to reduced cardiovascular reserve.
Vital signs—including systolic and diastolic blood pressure, mean arterial pressure (MAP), cardiac index, and bispectral index—were recorded at 3 time points: baseline, after loss of eyelash reflex, and after endotracheal intubation. Adverse events such as hypotension, hypertension, bradycardia, and body movements were also tracked.
Both groups reached the target depth of anesthesia in similar times—approximately 66 to 68 seconds. However, the ciprofol group showed greater cardiovascular stability. Hypotension occurred in only 20% of the ciprofol group, compared with 63% of the propofol group. Norepinephrine use was significantly lower in the ciprofol group, both in frequency and dosage.
Patients who were given ciprofol also maintained higher minimum blood pressure readings during induction. Minimum systolic blood pressure averaged 112.93 mm Hg, compared with 95.27 mm Hg in the propofol group. Similar patterns were observed for MAP and diastolic pressure, which suggested reduced cardiovascular suppression.
Other adverse events—including coughing, bradycardia, and movement—occurred at similar rates in both groups. All patients completed surgery without intraoperative complications.
The study excluded patients with a body mass index (BMI) of 28 or higher, significant liver or kidney impairment, or chronic sedative use. Given the limited sample size and follow-up duration, the researchers recommended further studies to evaluate long-term outcomes and assess efficacy in more diverse populations, including those with higher BMI.
The authors concluded that ciprofol may be a safer alternative to propofol in elderly patients who are more vulnerable to blood pressure instability during surgery.
The authors reported no conflicts of interest.
Source: frontiers
